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Med Command Chief Poses Bio-terrorism Questions

By Jim GaramoneAmerican Forces Press Service

WASHINGTON, Nov. 21, 2001  What kind of risk will the American people accept in regards to bio-terrorism? How does the government communicate better with the American people when a biological attack occurs?

These are just two of the questions Maj. Gen. John S. Parker, commanding general of the Army's Medical Research and Material Command at Fort Detrick, Md., posed during a presentation to the Fletcher Conference, Nov. 14.

Parker and his command have been involved in supporting public health and law enforcement efforts in the October anthrax mailings.

He said the anthrax mailings to news organizations and the Senate has redefined the battlefield. "In military terms we used to say, 'detect to avoid, detect to identify the threat, detect to protect,'" he said. "And, we were thinking of working in some far-off land with a face-to- face enemy. Now, all of a sudden, the battlefield is the continental United States."

"Detect to avoid" is not really possible. People are going to have to use facilities, such as post offices. And this leads America into assessing the risks posed by biological agents, including anthrax. "In my experiences with the recent anthrax contingency that occurred here, I learned one thing above all things," he said. "It boils down to one person who wants to know, 'Am I contaminated? Am I going to get ill? What should I do?' One person."

He said American scientists have the know-how to build equipment to detect a biological agent, but once the detector finds agent "X," the mystery really begins. "We'd better know an awful lot about 'X,' we'd better know what it is, what it's physiology is, what it's human effect is, what the therapy for 'X' is, and," Parker continued, "at what level do we provide therapy for an exposure to 'X'".

Parker explained the idea of decontamination took on a new meaning and a higher level of urgency when the battlefield was the United States. "Decontamination of people, places, things, papers, file drawers, your favorite pencil; they all became important in the decontamination process," he said. "Have we done enough research in the way of decontamination that it is done quickly, leaving no residues so that people can leave a building, have (the building) decontaminated and immediately return?"

As the country faces this new war, more questions must be answered. Defining the level at which contamination becomes a threat is one aspect researchers must contemplate. "Do we worry about one spore on the table?" Parker asked. "Do we worry about 100 spores in the rug? When do we worry?" The country needs to develop standards of what is safe and acceptable.

"I don't think we can guarantee no spores still exist in the Hart [Senate Office] Building," he said. "One tiny little spore is going to find some niche and survive. Now, is that a danger? Well, to some people it is."

Parker added he does not think one spore is a danger and we must identity the thresholds where people are safe. "As we walk through our world today, people are shaking hands, hugging, coughing, sneezing. Bacteria and viruses are invisible to us, but we seem to survive in a sea of pathogens that just would love to set up housekeeping in the rich environments of our physiological fluids," he said. "We seem to survive until one of those gets out of balance and we need to know when that balance is changed."

He said all Americans need information to confront bio- terrorism in the 21st Century. "The general public must have a basic knowledge of what is in their environment, how to act with it and how to take care of it if it becomes personal," he explained.

Polls show Americans expect "zero risk" from biological agents, but can the country afford zero risk, he asked. "Getting to zero risk is an isotonic curve in which there may be not enough dollars in the future to get there," he said. "At what level of risk will a human being feel safe?"

People take risks every day. They ride motorcycles without helmets, every day a thousand more children learn how to smoke, every day 50 people die on the highways because of drunk driving, he said. "There must be a level of risk that the American public will accept because those statistics prove it," Parker said. "Now, will they accept more than zero risk in a biological event?"

Parker said communication during a bio-terrorism attack is crucial. "Communication between people, communication between the agencies, communication with our customers and with the people that are involved in the incident," he said. "We must do better with communication.

"I've been in the United States Army for 38 years," he continued. "I've been in a lot of scenarios, be they real or be they exercises. And, in the after action report of almost every single one of those scenarios or exercises, it's been, 'We could have communicated better.'"

He said the country needs to think about improved communication and invest both money and manpower in this goal, adding that law enforcement and public health officials need to resolve competing needs. "When is material so important to a forensic investigation or to a prosecution that it cannot be shared openly in situations where it may have a public health consequence?" he asked.

Finally, the United States needs more information and testing of defenses against biological weapons. "What we need is a national test bed [for defenses against biological weapons]," Parker said. "Not just a military test bed, but a national test bed where entrepreneurs can bring their equipment to that national test bed and have it tested against a criteria."